Fundamentals Test 4 – Flashcards
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Barium enema
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Enema tube into rectum, barium sulfate flows into the colon, highlights your large intestine
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Double Contrast Barium
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Uses Barium sulfate but also delivers air into the colon to expand it
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barium swallow (upper GI series)
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Non invasive, NPO after midnight. Examines upper GI which includes the esophagus and to a lesser extent stomach. Barium swallowed a number of times in different positions. Fluoroscopy images are taken as the barium is swallowed
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Colonoscopy procedure
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Invasive, IV conscious sedation, NPO BEFORE PROCEDURE .Physician will insert a colonoscope, slowly guided. Air is also blown into scope to inflate colon. If adhesions are found can be removed part or all by tiny instruments passed through the scope
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Colonoscopy used to detect
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Early signs of cancer in the colon and rectum, also used to diagnose the causes of unexplained changes in bowel habits. Can see inflamed tissue abnormal growths, ulcers, and bleeding
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Gastroscopy procedure
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Invasive, IV conscious sedation, NPO after midnight. Provides images of the lining of the esophagus, stomach, and duodenum. Pharanyx is sprayed with a local anesthetic to prevent gagging. Scope inserted through mouth and down the esophagus. Air may be pumped into stomach to see better. May take tissue biopsies, remove abnormal growths or cauterize ulcers to stop bleeding
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Fecal occult blood
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Blood invisible in the feces
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stool guaiac test
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test to detect hidden blood in feces
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Used as a bowel cleansing lubricant
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Mineral oil, or a mineral oil retention enema
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Helps increase peristalsis and is a stimulant/irritant
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Ducolax, castor oil, senekot, senna tea
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Hypertonic stool softners
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Lactulose, miralax, MOM, fleet phosphorus soda, fleet enema, fleet sodium phosphate, enema
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Docusate
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Stool softener
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What is the daily recommended fluid intake if not contraindicated
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2000 to 3000ml a day
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What food sources and encouraged in a patient
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Raw fruits and vegetables, whole wheat grains, and increased fiber
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Signs of constipation include
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Abdominal fullness bloating, abdominal distention, pain on defecation, decreased frequency bowel movements ..oozing, liquid stool, small stool
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Primary/ Simple constipation
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Inadequate intake of fluid and fiber, ignoring urges, inactivity
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secondary constipation
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consequence of pathologic disorder such as a partial bowel obstruction surgery cancer
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iatrogenic constipation
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This type of constipation occurs as a consequence of other medical treatment eg: narcotic analgesia
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pseudoconstipation
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clients believe themselves to be constipated even though they are not
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Reasons for diarrhea
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Bowel disorder, way of eliminating tainted food, or intestinal pathogens, can also occur emotional stress, dietary irritations, or laxative abuse. Commonly accompanied by cramping
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What does BRAT diet stand for?
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Bananas, rice, applesauce and toast. Diet for diarrhea
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Colostomy
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The surgical creation of an artificial excretory opening between the colon and the body surface
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Stool consistency of ascending colon
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Liquid to semi liquid
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Stool consistency of transverse colon
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Liquid to semi formed
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Stool consistency of descending colon and sigmoid
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Semi formed to normal
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Rectal tube
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a tube inserted to aid in the expulsion of flatus
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How long does a rectal tube stay in and how far in does it go?
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For up to 20 minutes and 4 to 6 inches
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Dynamics
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How b/p and pulse work, what are you actually checking
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Pulse
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A wavelike sensation that can be palpated in peripheral artery, produced by the movement of blood during the hearts contraction
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B/P
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Th pressure the blood exerts against the walls of the artery in which it is contained
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Systolic
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Blood pressure in the arteries during contraction of the left ventricle.
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Diastolic
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the blood pressure during that part of the heartbeat when the hearts venticles are relaxing
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Temperature oral normal
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98.6
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Temperature Rectal norm
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99.6
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Temperature AXILLARY and ear canal norm
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97.6
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Sites for pulse rate
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Temporal artery, carotid artery, brachial arter, apical pulse, femoral artery, political artery, posterior tibial. Artery dorsal is pedis
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Sites for blood pressure
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Right or left arms, thigh and wrist
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How far do you go in for a rectal temp
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1 to 1.5inches
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Normal pulse range for adult
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60 to 100
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Bell of stethoscope
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Soft, low-pitched sounds (heart murmurs); place lightly on skin surface
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Diaphragm of stethoscope
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High-pitched sounds (lung, bowel, heart); place firmly against skin
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Normal range for b/p
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120/80
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Average respiration rate for an adult
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12 to 20 breaths per minute
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Factors that effect pulse
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Age, gender, body build, exercise, illness, hypoxia, stress, pain, temp, blood volume, b/p, drugs
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Factors that affect b/p
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ATHRS, ATRS, circadian rhythm, kidney disease, heart disease, smoking
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The stoma should be
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Pink and moist
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What happens if discharge is liquid from the stoma
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Use a wick to keep the skin dry
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What do you wash a stoma with
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Soap and water
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How often does a stoma faceplate need to be changed
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Every 5 days
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what is colostomy irrigation and why do we do it?
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Instilling fluid through the stoma into the colon. The purpose is to remove formed stool and in some cases to regulate the timing of bowel movements
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What is ileostomy?
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Done when necessary to remove or bypass entire colon and rectum (the entire thing is removed)
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Ileostomy drainage contains
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Irritating enzymes and acids that help break down food products, therefore extra care should be taken to keep output from coming in contact with the skin around the stoma
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Stoma skin complications
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Changes, rashes, or breakdown of skin as a result of leakage, mechanical irritation, or infection
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Candida albicans
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Build up of normal fungi on the skin leading to a yeast infection
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Peristomal irritation, peristomal skin excoriation
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Caused by barrier or pouch leakage, allergies, infection, radiation, skin stripping, and skin barrier removed in rough way
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Continent Ileostomy
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Koch pounch. Creates an internal pouch to collect ileal drainage. free of ostomy appliance. Removes stool or urine every 4 to 6 hours
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How often should someone change a pouch
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When its 1/3 full
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Cleansing enemas
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relieve constipation or empty bowel
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How many cc's of hypotonic solution is used in an enema and at what temp
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500 to 1000 ccs at 105 degrees
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What happens if during a cleansing enema the patient gets cramps
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DO NOT PULL OUT TUBE........ Slow or stop fluid
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What can be an issue if a person receives a cleansing enema and is dehydrated
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May absorb the water leading to fluid and electrolyte imbalance.
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oil retention enema
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Mineral oil held within the large intestine for at least 30 minutes. Softens stool so can be expelled more easily
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Can you use enemas laxatives and stool softners on a regular basis?
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No, only during the beginning of a bowel training program
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What shape is a rectal suppository?
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Oval or cone shaped- melts at body temperature
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What is suppository used for
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Aid in removal of stool, control vomiting, and reduce fever. NPO
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Common suppositories
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Tylenol, ASA, compazine, Tiguan, Phenergan, Cafegot, Dulcolax
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How to instill infection control
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Use of PPE, equipping a room to confine pathogens, disposal of contaminated linen,equipment, and supplies.
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Surgical asepsis (sterile technique)
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-Keep and area or object free of all microorganisms -Destroys all microorganisms and spores
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Can an item still be sterile past its expiration date?
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No
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What area is considered a zone of contamination within a sterile area
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The outer 1 inch
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Can you put items below waist level after being sterile if not why
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No, because they are not within critical view and therefore are considered contaminated
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When unwrapping a sterile pack how should you unfold the top point?
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Away from you, and final corner toward the body
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sitz bath
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soak of the perianal area. Reduces swelling and inflammation and promote healing of wounds after a hemmorhoidectomy, or an episiotomy
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adventitious breath sounds
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abnormal breath sound heard over the lungs
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Strider breath sounds
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High pitched sound on inspiration due to a partial airway obstruction of the laryngeal
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Wheezing (Expiratory or Inspiratory)
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An abnormal breath sound (whistling or rattling sound). (PE Respiratory/Chest)
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rhonchi (singular: rhonchus)
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loud rumbling sounds heard on auscultation of bronchi obstructed by sputum
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Crackles Fine
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Sound like popping sounds heard on inspiration
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Crackles Course
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Loud low pitch bubbling gurgling sound
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Pleural rub sounds
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Creaking or grating sounds. Two inflamed surfaces sliding by one another, such as in pleurisy. Walking on fresh snow or leather on leather
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Bowel sounds
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Wave like muscular contractions of the large and small intestines that move fluid and intestinal contents toward the rectum.
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What is normal for bowel sounds
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5 to 34 times a minutes. More frequent after eating. Sometimes nurse can hear blood pulsating through abdominal aorta
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Flatulence
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Accumulation of gas in the intestines causing the walls to stretch
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If someone passes a small amount of liquid stool and complains of stomach pain this person may be
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Constipated
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What can cause fecal impaction
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Unrelieved constipation, Retained barium dye, dehydration.
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Hemmorhoids
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Enlarged veins in the mucous membrane of the anal canal. And can also be external
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morals
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beliefs about what is fair and what is right or wrong
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Ethics
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The principles of right and wrong that guide an individual in making decisions
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values conflict
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Occurs when we must choose between two things, both of which are important to us.
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Moral uncertainty
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question as to whether a moral obligation exists
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moral distress
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a state that occurs when a person is unable to act in a way that he or she thinks is right.
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moral outrage
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occurs when an individual witnesses the immoral act of another but feels powerless to stop it
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moral dilemma
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problem that pits one moral value against another
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ethical dilemma
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a situation in which more than one side of an issue can be supported with valid arguments
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self awareness
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the act of thinking about ourselves
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Autonomy
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Independence
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Beneficence
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Doing good or causing good to be done; kindly action
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non maleficence
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to do no harm
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Justice
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Fairness; rightfulness
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negative euthanasia
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Failing to prevent death from natural causes
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Positive Euthanasia
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Taking specific steps to cause the pt's death.
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Assisted suicide
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Providing a seriously ill person with the means to commit suicide
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ONe ice cube equals
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30ml of fluid
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1 cup equals
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240cc/ml
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1 ounce equals
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30 mL
